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Helicobacter pylori infection is not associated with nonalcoholic fatty liver disease

World Journal of Gastroenterology 2016年第8期22卷 2592-2600页

作者： Myong Ki Baeg Seung Kew Yoon Sun-Hye Ko Yong-Sun Noh In-Seok Lee Myung-Gyu Choi Department of Internal Medicine The Catholic University of Korea College of Medicine

AIM: To determine whether Helicobacter pylori(H. pylori) infection confers a higher risk of nonalcoholic fatty liver disease(NAFLD).METHODS: Healthy people who underwent health screening were analyzed retrospectively. Inclusion criteria were age ≥ 20 years, history of H. pylori infection, and recorded insulin level. Participants were classified as H. pylori positive or negative according to 13 C urea breath tests. NAFLD was defined using the hepatic steatosis index(HSI) and NAFLD liver fat score(NAFLD-LFS). Those with an HSI > 36 or NAFLD-LFS >-0.640 were considered to have NAFLD. Multivariable logistic regression was performed to identify risk factors for NAFLD.RESULTS: Three thousand six hundred and sixtythree people were analyzed and 1636(44.7%) were H. pylori positive. H. pylori infection was associated with older age, male gender, hypertension, higher body mass index, and a dyslipidemic profile. HSI differed significantly between H. pylori positive and negative subjects(median 33.2, interquartile range(IQR) 30.0-36.2 for H. pylori-positive vs median 32.6, IQR 29.8-36.0 for negative participants, P = 0.005), but NAFLD-LSF did not [median-1.7, IQR-2.4--0.7 vs median-1.8, IQR-2.4-(-0.7), respectively, P = 0.122]. The percentage of people with NAFLD did not differbetween infected and uninfected groups: HIS, 26.9% vs 27.1%, P = 0.173; NAFLD-LFS, 23.5% vs 23.1%, P = 0.778. H. pylori infection was not a risk factor, but C-reactive protein concentration and smoking were significant risk factors for NAFLD.CONCLUSION: H. pylori infection is not a risk factor for NAFLD as indicated by HSI or NAFLD-LFS. Prospective, large-scale studies involving liver biopsies should be considered.

关键词： Helicobacter pylori nonalcoholic fatty liver disease Hepatic steatosis index nonalcoholic fatty live

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Adipokines and proinflammatory cytokines, the key mediators in the pathogenesis of nonalcoholic fatty liver disease

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World Journal of Gastroenterology 2014年第48期20卷 18070-18091页

作者： Sanja Stojsavljevi? Marija Gomer?i? Pal?i? Lucija Virovi? Juki? Lea Smir?i? Duvnjak Marko Duvnjak Department of Gastroenterology and Hepatology Clinic of Internal medicine Clinical hospital center "Sestre milosrdnice" 10000 Zagreb Croatia University Hospital for Diabetes Endocrinology and Metabolic Diseases Vuk Vrhovac 10000 Zagreb Croatia

nonalcoholic fatty liver disease(NAFLD)is a condition in which excess fat accumulates in the liver of a patient with no history of alcohol abuse or other causes for secondary hepatic steatosis.The pathogenesis of NAFLD and nonalcoholic steatohepatitis(NASH)has not been fully elucidated.The"two-hit"hypothesis is probably a too simplified model to elaborate complex pathogenetic events occurring in patients with NASH.It should be better regarded as a multiple step process,with accumulation of liver fat being the first step,followed by the development of necroinflammation and fibrosis.Adipose tissue,which has emerged as anendocrine organ with a key role in energy homeostasis,is responsive to both central and peripheral metabolic signals and is itself capable of secreting a number of proteins.These adipocyte-specific or enriched proteins,termed adipokines,have been shown to have a variety of local,peripheral,and central effects.In the current review,we explore the role of adipocytokines and proinflammatory cytokines in the pathogenesis of NAFLD.We particularly focus on adiponectin,leptin and ghrelin,with a brief mention of resistin,visfatin and retinol-binding protein 4 among adipokines,and tumor necrosis factor-α,interleukin(IL)-6,IL-1,and briefly IL-18 among proinflammatory cytokines.We update their role in NAFLD,as elucidated in experimental models and clinical practice.

关键词： nonalcoholic fatty liver disease Cytokines Adipoki

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Effects of probiotics on nonalcoholic fatty liver disease:A meta-analysis

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World Journal of Gastroenterology 2013年第40期19卷 6911-6918页

作者： Yan-Yan Ma Lin Li Chao-Hui Yu Zhe Shen Li-Hua Chen You-Ming Li Department of Gastroenterology the First Affiliated HospitalZhejiang University School of Medicine

AIM:To investigate the relationship between the gutliver axis and nonalcoholic fatty liver disease(NAFLD),we performed a meta-analysis to evaluate the effects of probiotic therapy in NAFLD.METHODS:We searched PubMed,Medline,Embase,Web of Science,the Cochrane Library and Chinese Biomedicine Database for all relevant randomized controlled trials on probiotics in patients with NAFLD/nonalcoholic steatohepatitis(NASH).A statistical analysis was performed using RevMan 5.0 software.RESULTS:Four randomized trials involving 134 NAFLD/NASH patients were included.The results showed that probiotic therapy signifcantly decreased alanine aminotransferase(ALT),aspartate transaminase(AST),total-cholesterol(T-chol),high density lipoprotein(HDL),tumor necrosis factor(TNF)-αand homeostasis model assessment of insulin resistance(HOMAIR)[ALT:weighted mean difference(WMD)-23.71,95%CI:-33.46--13.95,P<0.00001;AST:WMD-19.77,95%CI:-32.55--7.00,P=0.002;T-chol:WMD-0.28,95%CI:-0.55--0.01,P=0.04;HDL:WMD-0.09,95%CI:-0.16-0.01,P=0.03;TNF-α:WMD-0.32,95%CI:-0.48--0.17,P<0.0001;HOMA-IR:WMD-0.46,95%CI:-0.73--0.19,P=0.0008].However,the use of probiotics was not associated with changes in body mass index(BMI),glucose(GLU)and low density lipoprotein(LDL)(BMI:WMD 0.05,95%CI:-0.18-0.29,P=0.64;GLU:WMD 0.05,95%CI:-0.25-0.35,P=0.76;LDL:WMD-0.38,95%CI:-0.78-0.02,P=0.06).CONCLUSION:Probiotic therapies can reduce liver aminotransferases,total-cholesterol,TNF-αand improve insulin resistance in NAFLD patients.Modulation of the gut microbiota represents a new treatment for NAFLD.

关键词： Probiotics nonalcoholic fatty liver disease nonalcoholic steatohepatitis Liver function Insulin resistance Meta-analysis

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Peroxisome proliferator-activated receptor-delta agonist ameliorated inflammasome activation in nonalcoholic fatty liver disease

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World Journal of Gastroenterology 2015年第45期21卷 12787-12799页

作者： Hyun Jung Lee Jong Eun Yeon Eun Jung Ko Eileen L Yoon Sang Jun Suh Keunhee Kang Hae Rim Kim Seoung Hee Kang Yang Jae Yoo Jihye Je Beom Jae Lee Ji Hoon Kim Yeon Seok Seo Hyung Joon Yim Kwan Soo Byun Department of Internal Medicine Korea University College of Medicine

AIM: To evaluate the inflammasome activation and the effect of peroxisome proliferator-activated receptors(PPAR)-δ agonist treatment in nonalcoholic fatty liver disease(NAFLD) models.METHODS: Male C57BL/6J mice were classified according to control or high fat diet(HFD) with or without PPAR-δ agonist(GW) over period of 12 wk [control, HFD, HFD + lipopolysaccharide(LPS), HFD + LPS + GW group]. Hep G2 cells were exposed to palmitic acid(PA) and/or LPS in the absence or presence of GW.RESULTS: HFD caused glucose intolerance and hepatic steatosis. In mice fed an HFD with LPS, caspase-1 and interleukin(IL)-1β in the liver were significantly increased. Treatment with GW ameliorated the steatosis and inhibited overexpression of pro-inflammatory cytokines. In Hep G2 cells, PA and LPS treatment markedly increased m RNA of several nucleotide-binding andoligomerization domain-like receptor family members(NLRP3, NLRP6, and NLRP10), caspase-1 and IL-1β. PA and LPS also exaggerated reactive oxygen species production. All of the above effects of PA and LPS were reduced by GW. GW also enhanced the phosphorylation of AMPK-α.CONCLUSION: PPAR-δ agonist reduces fatty acidinduced inflammation and steatosis by suppressing inflammasome activation. Targeting the inflammasome by the PPAR-δ agonist may have therapeutic implication for NAFLD.

关键词： nonalcoholic fatty liver disease nonalcoholic stea

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Adipokines and C-reactive protein in relation to bone mineralization in pediatric nonalcoholic fatty liver disease

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World Journal of Gastroenterology 2013年第25期19卷 4007-4014页

作者： Lucia Pacifico Mario Bezzi Concetta Valentina Lombardo Sara Romaggioli Flavia Ferraro Stefano Bascetta Claudio Chiesa Department of Pediatrics Sapienza University of Rome Department of Radiological Sciences Sapienza University of Rome Department of Radiological Sciences Sapienza University of Rome 00161 Rome Italy Institute of Translational Pharmacology National Research Council

AIM: To investigate bone mineral density (BMD) in obese children with and without nonalcoholic fatty liver disease (NAFLD); and the association between BMD and serum adipokines, and high-sensitivity C-reactive protein (HSCRP). METHODS: A case-control study was performed. Cases were 44 obese children with NAFLD. The diagnosis of NAFLD was based on magnetic resonance imaging (MRI) with high hepatic fat fraction (≥ 5%). Other causes of chronic liver disease were ruled out. Controls were selected from obese children with normal levels of aminotransferases, and without MRI evidence of fatty liver as well as of other causes of chronic liver diseases. Controls were matched (1-to 1-basis) with thecases on age, gender, pubertal stage and as closely as possible on body mass index-SD score. All participants underwent clinical examination, laboratory tests, and whole body (WB) and lumbar spine (LS) BMD by dual energy X-ray absorptiometry. BMDZ-scores were calcu- lated using race and gender specific LMS curves. RESULTS: Obese children with NAFLD had a significantly lower LS BMDZ-score than those without NAFLD [mean, 0.55 (95%CI: 0.23-0.86) vs 1.29 (95%CI: 0.95-1.63); P nonalcoholic steatohepatitis (NASH), while 15 (43%) no NASH. Compared to children without NASH, those with NASH had a significantly lower LS BMD Z-score [mean, 0.27 (95%CI: -0.17-0.71) vs 0.75 (95%CI: 0.13-1.39); P < 0.05] as well as a significantly lower WB BMD Z-score [1.38 (95%CI: 0.89-1.17) vs 1.93 (95%CI: 1.32-2.36); P < 0.05]. In multiple regression analysis, NASH (standardized β coefficient, -0.272; P < 0

关键词： Bone mineralization Dual energy X-ray absorptiometry Adipokines C-reactive protein nonalcoholic fatty liver disease Children

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Herbal medicines and nonalcoholic fatty liver disease

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World Journal of Gastroenterology 2016年第30期22卷 6890-6905页

作者： Hong Yao Yu-Jie Qiao Ya-Li Zhao Xu-Feng Tao Li-Na Xu Lian-Hong Yin Yan Qi Jin-Yong Peng College of Pharmacy Dalian Medical University Dalian 116044 Liaoning Province China

nonalcoholic fatty liver disease(NAFLD), which is characterized by excessive fat accumulation in the liver of patients who consume little or no alcohol, becomes increasingly common with rapid economic development. Long-term excess fat accumulation leads to NAFLD and represents a global health problem with no effective therapeutic approach. NAFLD is considered to be a series of complex, multifaceted pathological processes involving oxidative stress, inflammation, apoptosis, and metabolism. Over the past decades, herbal medicines have garnered growing attention as potential therapeutic agents to prevent and treat NAFLD, due to their high efficacy and low risk of side effects. In this review, we evaluate the use of herbal medicines(including traditional Chinese herbal formulas, crude extracts from medicinal plants, and pure natural products) to treat NAFLD. These herbal medicines are natural resources that can inform innovative drug research and the development of treatments for NAFLD in the future.

关键词： Herbal medicines nonalcoholic fatty liver disease Natural product Traditional Chinese medicines Revi

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Exploring the metabolic syndrome: nonalcoholic fatty pancreas disease

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World Journal of Gastroenterology 2016年第34期22卷 7660-7675页

作者： Roberto Catanzaro Biagio Cuffari Angelo Italia Francesco Marotta Department of Clinical and Experimental Medicine Gastroenterology and Hepatology ServiceInternal Medicine UnitUniversity Hospital Policlinico 'G. Rodolico'University of Catania 95123 Catania Italy ReGenera Research Group for Aging-Intervention 20144 Milano Italy

After the first description of fatty pancreas in 1933,the effects of pancreatic steatosis have been poorly investigated,compared with that of the liver. However,the interest of research is increasing. Fat accumulation,associated with obesity and the metabolic syndrome(Met S),has been defined as "fatty infiltration" or "nonalcoholic fatty pancreas disease"(NAFPD). The term "fatty replacement" describes a distinct phenomenon characterized by death of acinar cells and replacement by adipose tissue. Risk factors for developing NAFPD include obesity,increasing age,male sex,hypertension,dyslipidemia,alcohol and hyperferritinemia. Increasing evidence support the role of pancreatic fat in the development of type 2 diabetes mellitus,Met S,atherosclerosis,severe acute pancreatitis and even pancreatic cancer. Evidence exists that fatty pancreas could be used as the initial indicator of "ectopic fat deposition",which is a key element of nonalcoholic fatty liver disease and/or Met S. Moreover,in patients with fatty pancreas,pancreaticoduodenectomy is associated with an increased risk of intraoperative blood loss and post-operative pancreatic fistula.

关键词： Metabolic syndrome nonalcoholic fatty liver disease Pancreatic steatosis Pancreatic lipomatosis nonalcoholic fatty pancreas disease Fatty pancreas Pancreatic fat Pancreatic fatty replacement Pancreatic fatty infiltration Pancreatic cancer

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Oily fish, coffee and walnuts: Dietary treatment for nonalcoholic fatty liver disease

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World Journal of Gastroenterology 2015年第37期21卷 10621-10635页

作者： Vikas Gupta Xian-Jun Mah Maria Carmela Garcia Christina Antonypillai David van der Poorten Department of Gastroenterology and Hepatology Division of MedicineUniversity of Sydney at Westmead Hospital

Rates of non-alcoholic fatty liver disease(NAFLD) are increasing worldwide in tandem with the metabolic syndrome, with the progressive form of disease, nonalcoholic steatohepatitis(NASH) likely to become the most common cause of end stage liver disease in the not too distant future. Lifestyle modification and weight loss remain the main focus of management in NAFLD and NASH, however, there has been growing interest in the benefit of specific foods and dietary components on disease progression, with some foods showing protective properties. This article provides an overview of the foods that show the most promise and their potential benefits in NAFLD/NASH, specifically; oily fish/fish oil, coffee, nuts, tea, red wine, avocado and olive oil. Furthermore, it summarises results from animal and human trials and highlights potential areas for future research.

关键词： Non-alcoholic fatty liver disease nonalcoholic ste

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Physical activity support or weight loss counseling for nonalcoholic fatty liver disease?

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World Journal of Gastroenterology 2014年第29期20卷 10128-10136页

作者： Luca Montesi Chiara Caselli Elena Centis Chiara Nuccitelli Simona Moscatiello Alessandro Suppini Giulio Marchesini Unit of Metabolic Diseases and Clinical Dietetics "Alma Mater Studiorum" University S. Orsola-Malpighi Hospital

AIM:To determine the clinical effectiveness of intense psychological support to physical activity(PA)in nonalcoholic fatty liver disease(NAFLD),compared with cognitive-behavioral treatment(CBT).METHODS:Twenty-two NAFLD cases received support to exercise,tailored to their motivational needs(PA group).The effects on body weight,physical fitness[6-min walk test,VO2max and the PA-rating(PA-R)questionnaire]and body fat(fatty liver indices and visceral adiposity index)were compared with data obtained in 44 NAFLD subjects enrolled in a CBT program for weight loss,after adjustment for propensity score,calculated on baseline data.Measurements were performed at baseline,at 4-mo and one-year follow-up.Changes in anthropometric,biochemical and PA parameters were tested by repeated measurement ANOVA.Outcome results were tested by logistic regression analysis.RESULTS:At the end of the intensive program,BMI was less significantly reduced in the PA group(-1.09±1.68 kg/m2 vs-2.04±1.42 kg/m2 in the CBT group,P=0.019)and the difference was maintained at 1-year follow-up(-0.73±1.63 vs-1.95±1.88,P=0.012)(ANOVA,P=0.005).PA-R was similar at baseline,when only 14%of cases in PA and 36%in CBT(P=0.120)recorded values≥3.At 4 mo,a PA-R≥3 was registered in 91%of PA and 46%of CBT,respectively(P7%was significantly associated with CBT group at one year(OR=6.21;95%CI:1.23-31.30),whereas PA-R>3 was associated with PA group(10.31;2.02-52.63).Liver enzymes decreased to values within normal limits in 36%of PA cases and61%of CBT(P<0.070).Estimated liver fat(Kotronen index)fell below the fatty liver threshold in 36%of PA and 34%and CBT cases at one-year(not different).Also the fatty liver index and the v

关键词： nonalcoholic fatty liver disease Behavior treatmen

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Radiologic evaluation of nonalcoholic fatty liver disease

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World Journal of Gastroenterology 2014年第23期20卷 7392-7402页

作者： Seung Soo Lee Seong Ho Park Department of Radiology and Research Institute of Radiology University of Ulsan College of MedicineAsan Medical CenterSeoul 138-736South Korea

nonalcoholic fatty liver disease(NAFLD)is a frequent cause of chronic liver diseases,ranging from simple steatosis to nonalcoholic steatohepatitis(NASH)-related liver cirrhosis.Although liver biopsy is still the gold standard for the diagnosis of NAFLD,especially for the diagnosis of NASH,imaging methods have been increasingly accepted as noninvasive alternatives to liver biopsy.Ultrasonography is a well-established and costeffective imaging technique for the diagnosis of hepatic steatosis,especially for screening a large population at risk of NAFLD.Ultrasonography has a reasonable accuracy in detecting moderate-to-severe hepatic steatosis although it is less accurate for detecting mild hepatic steatosis,operator-dependent,and rather qualitative.Computed tomography is not appropriate for general population assessment of hepatic steatosis given its inaccuracy in detecting mild hepatic steatosis and potential radiation hazard.However,computed tomography may be effective in specific clinical situations,such as evaluation of donor candidates for hepatic transplantation.Magnetic resonance spectroscopy and magnetic resonance imaging are now regarded as the most accurate practical methods of measuring liver fat in clinical practice,especially for longitudinal followup of patients with NAFLD.Ultrasound elastography and magnetic resonance elastography are increasingly used to evaluate the degree of liver fibrosis in patients with NAFLD and to differentiate NASH from simple steatosis.This article will review current imaging methods used to evaluate hepatic steatosis,including the diagnostic accuracy,limitations,and practical applicability of each method.It will also briefly describe the potential role of elastography techniques in the evaluation of patients with NAFLD.

关键词： nonalcoholic fatty liver disease nonalcoholic stea

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